Onlay partial denture

Anterior teeth attrition Vertical dimension decrease RPD - abrasion

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A. Etiology
Parafunctional occlusal habits
Chronic bruxism  Other oral habits : biting on needles, pipe stems, pencils, hairpins


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A. Etiology
Abrasion : diet chewing of abrasive materials (rice, tabacco)
Definition : defined as the wearing away of tooth tissue by external agents  Occlusal abrasion is usually attributed to diet, chewing of abrasive.  Environment factors : constant exposure to dust and grit

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A. Etiology
Erosion : chemical action
Result from excessive intake citrus juices, cola, chronic vomiting  Incisal edge, lingual or occlusal surface : cupped-out appearance (unbalanced occlusal force)


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Evaluation of Vertical Dimension

OVD : occlusal vertical dimension VDO : vertical dimension of occlusion VDR : vertical dimension of rest

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C. Methods of evaluation
Posterior support History of wear Phonetic evaluation Inter-occlusal distance Facial appearance

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C. Methods of evaluation
Posterior support
Loss of posterior support is the most common cause of decreased occlusal vertical dimension  Posterior collapsar : combination of missing, tipping, rotated and broken down teeth


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C. Methods of evaluation
Phonetic evaluation : speaking space S sound q incisal edge incisal edge 1mm inferior and lingual q , 1mm VD loss

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C. Methods of evaluation
Inter-occlusal distance ; VDO, VDR 3mm excessive wer . . complete denture VD myomonitor .

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Approaching technique
OVD r


q .

Concepts of conservative treatment  Trial period with interim prosthesis

Transitional RPD (desired OVD)  Use of acrylic splint  Use of provisional restoration


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Interim removable partial denture

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Initial patient assessment

Intraoral examination Extraoral examination Smile analysis Phonetic evaluation Initial prostheses assessment

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Initial patient assessment

Intra-oral examination
Excessive loss of tooth structure  Healthy periodontum with sufficient bone  Lack of posterior occlusion  Class I jaw relationship


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Initial patient assessment

Extra-oral examination
Slight decrease in facial height  Inversion of maxillary lip  Inter-occlusal rest space of 3 to 4mm


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Initial patient assessment

Smile analysis
No touch of maxillary teeth to lower lip  Straight maxillary incisal edge alignment to lower lip  Increase vestibular space


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Initial patient assessment

Phonetic evaluation
F-V position inadequate in vertival plane  S position : acquired Ssound deficiency


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Initial patient assessment

Initial prostheses assessment
Poor plane of occlusion  Lack of occlusion as a result of excessive wear of acrylic resin  Inadequate border extensions


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To determinate the VD
4mm increase ( anterior incisor area) Direct assessment technique Diagnostic wax-up technique

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Mounted diagnostic wax-up

To assess the patients tolerance & acceptance of restored OVD Use face-bow, centric relation, condylar angle (protrusive record, lateral check bite) Mount the semi-adjustable articulator

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